Frequently Asked Questions

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EDI

Can I submit COB claims electronically?

Yes, Molina and our connected Clearinghouses fully support electronic COB.

Do I need to submit a certain volume of claims to send EDI?

No, any number of claims via EDI saves both time and money.

Which Clearinghouses are currently available to submit EDI claims to Molina?

See Clearinghouses

What claims transactions are currently accepted for EDI transmission?

837P (Professional claims), 837I (Institutional claims).

Where can I find more information on the HIPAA transactions?

See companion guides and State Guide websites

How do I exchange the 270/271 Eligibility Inquiry?

Molina does not directly exchange the Eligibility transactions. The transactions may be sent to Molina's contracted clearinghouse The SSI Group to verify Eligibility.

How do I exchange the 276/277 Claim Status Inquiry/Response?

Molina does not directly exchange the Claim Status transactions. The transactions may be sent to Molina's contracted clearinghouse The SSI Group to verify Claim Status.

What do I do if I still have questions?

Contact Us

ERA-EFT

Does Molina offer Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT)?

  • Yes. Molina Healthcare offers ERA/EFT through Change Healthcare, who has contracted with ECHO Health for these services.  Please refer to the ERA/EFT enrollment information section for more information.

Do I get charged for being configured for EFT through Change Healthcare/ECHO Health?

  • No.  This is a FREE service for you to take advantage of.  Molina Healthcare covers any fees related to access to your payment information as well as the EFT payment.

Why does registration for EFT/ERA require that I provide historical payment information from Molina or with ECHO?

This information is necessary to ensure that the person registering the Provider has the authority to do so and is aware of the Explanation of Payment-EOP (aka Remittance Advice) name and address information – while registering with ECHO.  (Please refer to the below FAQ if you do not have historical payment information from Molina or with ECHO.)

  • An initial payment to at least one Tax ID is necessary to become eligible for EFT thru ECHO Health.
  • If the Provider has multiple NPIs associated to one Tax ID, then only one affiliation needs a paper check number or ECHO draft number.
  • If the Provider has multiple Tax IDs, then each Tax ID would need a minimum of one paper check from Molina or ECHO draft number.

I do not have a Molina payment number or an ECHO draft number. How do I register for EFT?

If you do not have a Molina check number or ECHO draft number from another payer, please contact ECHO Customer Support at (888) 834-3511 for assistance.  They can help register you for EFT using their alternative EFT registration process.

I called ECHO Health, and they say I'm registered, but I'm still receiving paper checks or Virtual Cards?

Ensure you have completed the following verification steps:
  • Signed and returned an ACH Authorization form as well as a voided check or bank verification letter for the account you designated to receive your deposits to ECHO. It takes 24-48 hours for ECHO to process these documents once received
  • Verified that the bank account and routing information provided to ECHO is valid (this could possibly cause delays in finalizing of your set-up).
  • Checked the status of an EFT enrollment, by calling ECHO customer support at (888) 834-3511 or via email at edi@echohealthinc.com.

Can I make a change to my bank account information on ECHO Health?

  • Yes.  To change your bank information, contact ECHO customer support at (888) 834-3511.

How long does it normally take for the EFT payment to get applied to my bank account (after I am a registered provider)?

  • For verified bank accounts, the money is transferred within 5 business days of Molina’s payment process. Your bank may vary on when they release the funds into your account. Please check with your bank on specifics.

How do I view my EOPs that are associated with the EFT payment now that I am no longer receiving the paper check?

How long does my EOP remain available on ProviderPayments.com for view/download/save?

  • The EOP PDF will remain online for up to 24 months after original payment.

If I have a Clearinghouse that manages my payables, can I have my (ERA) EDI 835 files go directly to them?

  • Yes. You can specify your clearinghouse to receive 835 files when can complete the “Electronic Remittance Advice Information” section of the EFT application.
  • If you have a clearinghouse currently and wish to change, you will need to contact ECHO customer support at (888) 834-3511 or via email at edi@echohealthinc.com.